Active NPI
Betty Odak, LMFT
- Marriage & Family Therapist
- Redlands, CA
National Provider Identifier
1326218611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 52001
- Practice address
- 535 W State St
C
Redlands, CA 92373-4662 - Phone
- (562) 522-8008
- Fax
- (909) 335-5991
- NPI assigned
- Mar 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 52001 | CA | Primary |
Addresses
Primary practice location
535 W State St
C
Redlands, CA 92373-4662
Mailing address
PO Box 10908
San Bernardino, CA 92423-0908
Phone (562) 522-8008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52001 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cross Cultural Marriage and Familytherapy Counselling Ce | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Marriage & Family Therapist
- Redlands, CA
- NPI 1063751303
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451433600000",
"number": "1326218611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10908",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924230908",
"telephone_number": "562-522-8008",
"fax_number": "909-335-5991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 W STATE ST",
"address_2": "C",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923734662",
"telephone_number": "562-522-8008",
"fax_number": "909-335-5991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODAK",
"first_name": "BETTY",
"name_prefix": "Ms.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-03",
"last_updated": "2015-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "52001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.